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  5. FIELDCREST DENTAL, P.C.

FIELDCREST DENTAL, P.C.

Company Details

Entity Name: FIELDCREST DENTAL, P.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 21 Nov 2012
Company Number: CORP_68589851
File Number: 68589851
Type of Business: Incorporated under the Professional Service Corporation Act
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FIELDCREST DENTAL, P.C. 401(K) PLAN 2023 461278087 2024-10-14 FIELDCREST DENTAL, P.C. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 8154522513
Plan sponsor’s address 528 JOHNSON ST., MINONK, IL, 61760

Signature of
Role Plan administrator
Date 2024-10-14
Name of individual signing LEO J. WAYMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-10-14
Name of individual signing LEO J. WAYMAN
Valid signature Filed with authorized/valid electronic signature
FIELDCREST DENTAL, P.C. 401(K) PLAN 2022 461278087 2023-10-14 FIELDCREST DENTAL, P.C. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 8154522513
Plan sponsor’s address 528 JOHNSON ST., MINONK, IL, 61760

Signature of
Role Plan administrator
Date 2023-10-14
Name of individual signing LEO J. WAYMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-10-14
Name of individual signing LEO J. WAYMAN
Valid signature Filed with authorized/valid electronic signature
FIELDCREST DENTAL, P.C. 401(K) PLAN 2021 461278087 2022-10-17 FIELDCREST DENTAL, P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 8154522513
Plan sponsor’s address 528 JOHNSON ST., MINONK, IL, 61760

Signature of
Role Plan administrator
Date 2022-10-17
Name of individual signing LEO J. WAYMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-10-17
Name of individual signing LEO J. WAYMAN
Valid signature Filed with authorized/valid electronic signature
FIELDCREST DENTAL, P.C. 401(K) PLAN 2020 461278087 2021-10-15 FIELDCREST DENTAL, P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 8154522513
Plan sponsor’s address 528 JOHNSON ST., MINONK, IL, 61760

Signature of
Role Plan administrator
Date 2021-10-15
Name of individual signing LEO J. WAYMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-10-15
Name of individual signing LEO J. WAYMAN
Valid signature Filed with authorized/valid electronic signature
FIELDCREST DENTAL, P.C. 401(K) PLAN 2019 461278087 2020-10-13 FIELDCREST DENTAL, P.C. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 8154522513
Plan sponsor’s address 528 JOHNSON ST., MINONK, IL, 61760

Signature of
Role Plan administrator
Date 2020-10-13
Name of individual signing LEO J. WAYMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-10-13
Name of individual signing LEO J. WAYMAN
Valid signature Filed with authorized/valid electronic signature
FIELDCREST DENTAL, P.C. 401(K) PLAN 2018 461278087 2019-10-13 FIELDCREST DENTAL, P.C. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 8154522513
Plan sponsor’s address 528 JOHNSON ST., MINONK, IL, 61760

Signature of
Role Plan administrator
Date 2019-10-13
Name of individual signing LEO J. WAYMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-10-13
Name of individual signing LEO J. WAYMAN
Valid signature Filed with authorized/valid electronic signature
FIELDCREST DENTAL, P.C. 401(K) PLAN 2017 461278087 2018-10-14 FIELDCREST DENTAL, P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 8154522513
Plan sponsor’s address 528 JOHNSON ST., MINONK, IL, 61760

Signature of
Role Plan administrator
Date 2018-10-14
Name of individual signing LEO J. WAYMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-10-14
Name of individual signing LEO J. WAYMAN
Valid signature Filed with authorized/valid electronic signature
FIELDCREST DENTAL, P.C. 401(K) PLAN 2016 461278087 2017-10-02 FIELDCREST DENTAL, P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 8154522513
Plan sponsor’s address 528 JOHNSON ST., MINONK, IL, 61760

Signature of
Role Plan administrator
Date 2017-10-02
Name of individual signing LEO J. WAYMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-10-02
Name of individual signing LEO J. WAYMAN
Valid signature Filed with authorized/valid electronic signature
FIELDCREST DENTAL, P.C. 401(K) PLAN 2015 461278087 2016-10-14 FIELDCREST DENTAL, P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 8154522513
Plan sponsor’s address 528 JOHNSON ST., MINONK, IL, 61760

Signature of
Role Plan administrator
Date 2016-10-14
Name of individual signing LEO J. WAYMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-10-14
Name of individual signing LEO J. WAYMAN
Valid signature Filed with authorized/valid electronic signature
FIELDCREST DENTAL, P.C. 401(K) PLAN 2014 461278087 2015-10-08 FIELDCREST DENTAL, P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 8154522513
Plan sponsor’s address 203 E. SANTA FE AVENUE, TOLUCA, IL, 61369

Signature of
Role Plan administrator
Date 2015-10-08
Name of individual signing LEO J. WAYMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-10-08
Name of individual signing LEO J. WAYMAN
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
PATRICK M HAMPER, 203 E SANTA FE AVE, TOLUCA, 61369, MARSHALL Agent 2012-11-21

President

Name and Address Role
PATRICK HAMPER, 2814 HUNTINGTON RD BLOOMINGTON IL 61704 President

Secretary

Name and Address Role
STEPHANIE HAMPER, 2814 HUNTINGTON RD BLOOMINGTON IL 61704 Secretary

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
NO PAR COMMON No data Voting Rights 10000 1200000 No data

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 23 Dec 2024

Sources: Illinois Office of the Secretary of State

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